摘要
目的 探讨青少年甲状腺癌的临床病理特点、最佳治疗方法及预后。方法 86例患者均以手术治疗为主 ,辅以内分泌治疗 ,少数患者加13 1Ⅰ内照射治疗。结果 全组乳头状癌 73例(84.9% ) ,滤泡状癌 6例 (7.0 % ) ,乳头滤泡状癌 4例 (4.7% ) ,髓样癌 3例 (3 .5% )。颈部淋巴结转移59例 (68.6% ) ,其中双侧甲状腺癌并双颈部淋巴结转移者 16例 ,占 2 7.1%。肺转移 11例。术后复发6例。本组颈部淋巴结转移率、双侧甲状腺受侵犯伴双颈淋巴结转移率、肺转移率均明显高于成年人。 84例获 5年以上随访 ,5年生存率 95.3 % (82 /86)。 41例获 10年以上随访 ,10年生存率 87.8%(3 6/41)。结论 青少年甲状腺癌颈部肿块临床表现大多数无特异性 ,难以与其他颈部肿块鉴别 ,易误诊 ,应引起临床高度重视。治疗手段以手术为主 ,预后良好。既使已有肺转移 ,手术加13
Objective To investigate the clinico-pathologic characteristics, trea tment and prognosis of thyroid carcinoma in childhood and adolescents. Methods From 1984 to 1997, 86 cases with thyroid carcinoma in childhood and adolescent treated were summarized. Results All cases underwent operation with adjuvant ther apy. Pathologically, papillary carcinoma was diagnosed in 73 (84.9%), follicular carcinoma in 6 (7%), papillary-follicular carcinoma in 4 (4.7%) and medullary c arcinoma in 3 (3.5%). Cervical lymph node metastasis was found in 59 cases (68.6 %), 16 of which with both thyroid carcinoma and bilateral cervical lymph node me tastasis (27.1%). Lung metastasis was found in 11 cases. Recurrence occurred in 6 cases after operation. Compared with the thyroid carcinoma in adult patients, cervical lymph node metastasis, bilateral involvement of the thyroid gland with bilateral cervical nodes and lung metastasis rate were more commonly seen in chi ldhood and adolescence. All but 2 patients had been followed up for more than 5 years, 41 patients for more than 10 years. The 5-year and 10-year survival rat e was 95.3%(82/86) and 87.8%(36/41), respectively. Conclusion The clinical manifes tations of childhood and adolescent thyroid cancer are generally not pathognosti c which may lead to misdiagnosis. Surgery is the main method in the comprehensiv e treatment with a good prognosis. The therapy with 131 Ⅰ after operatio n was beneficial for some patients accompanied with lung metastasis
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2004年第1期49-51,共3页
Chinese Journal of Oncology
